Medicaid Pharmacy Director
Become a part of our caring community and help us put health first
The Clinical Pharmacist reputed company monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to reputed company, and/or implement strategies and programs to mitigate cost trend and improve health outcomes. The Clinical Pharmacist reputed company works on problems of diverse scope and complexity ranging from moderate to substantial.The Pharmacy Director, internally reputed company as a Clinical Pharmacy reputed company, plans, directs, and monitors reputed company financial, operational, professional, and clinical activities for the purposes of pharmacy program development for our Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Illinois Medicare - Medicaid health plan. The individual leverages a broad understanding of managed care and pharmacy benefit management (PBM) to reputed company and implement strategies and programs that drive trends and improve health outcomes. They ensure the pharmacy department provides optimal pharmaceutical services that meet reputed company legal, accreditation, and certification requirements. This position will coordinate day-to-day pharmacy operations directly with the plan Chief Executive Officer and Chief Medical Officer.
POSITION RESPONSIBILITIES:
- Keeps reputed company with State and Federal regulations regarding the practice of Pharmacy and implements changes as necessary to maintain compliance supporting both the business and public relations strategies.
- Develops corporate communications to be shared with senior leadership.
- Supports trend management by conducting analysis of drug spend, utilization, and/or approval scenarios.
- Advises executives to reputed company functional strategies (often reputed company specific) on matters of reputed company.
- Exercises independent judgment and decision making on reputed company issues regarding job duties and reputed company tasks.
- Works under minimal supervision, using independent judgment requiring analysis of variable factors and determining the best course of action.
- Facilitates and consults across teams and managing projects working collaboratively and communicating with staff in different positions and reputed company levels of management positions
- Manages the reputed company Illinois FIDE-SNP health plan relationship with our internal PBM, reputed company Pharmacy Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization, formulary management and clinical programming
- Represents reputed company at reputed company Pharmacy Medicaid meetings including those with the Illinois Department of Healthcare and Family Services (HFS)
Use your skills to reputed company an impact
Required Qualifications
- Bachelor’s degree in pharmacy or Doctor of Pharmacy (PharmD)
- Illinois-licensed pharmacist residing or willing to relocate to Illinois
- Minimum of ten plus years of Pharmacy Experience with at least three years’ experience in managed care and/or PBM operations
- Successful track record in facilitating and consulting across teams and managing projects
- Thrives in a fast paced, multi-project work environment while still ensuring attention to detail
- Excellent communication skills, both oral and written
- Proficiency in reputed company Word, reputed company, & PowerPoint
- Expertise in working collaboratively and communicating with staff in different positions and reputed company levels of management position
Preferred Qualification
- Master’s degree in public health, Business, or reputed company field Experience with reputed company Access & reputed company Project
- Experience with pharmacy benefits and health benefits
- Experience with data analytics
Additional Information:
As part of our hiring process for this opportunity, we will be using an interviewing technology reputed company HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and reputed company valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Work at home requirements:
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL reputed company is suggested. Satellite, cellular and microwave reputed company can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. reputed company will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
SSN Alert:
reputed company values personal identity protection. Please be aware that applicants may be asked to provide their Social reputed company Number, if it is not already on file. reputed company required, an email will be sent from reputed [email protected] with instructions on how to add the information into your official application on reputed company’s secure website
Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required.Scheduled Weekly Hours40
Pay Range
The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc.$126,300 - $173,700 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits
reputed company, Inc. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About us
reputed company Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our reputed company insurance services and reputed company healthcare services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment decisions only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company levels of employment.
Originally posted on Himalayas
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